Comparative Effectiveness of Ovulation Induction Therapy in Women with Polycystic Ovarian Syndrome
Objectives: To evaluate the efficacy of letrozole plus metformin in comparison to clomiphene citrate (CC) alone and clomiphene citrate plus metformin in ovulation induction treatment, in Pakistani’s infertile women with polycystic ovarian syndrome (PCOS).
Study Design: Prospective randomized controlled study
Setting: Women & Children Teaching Hospital Bannu and private practice setting from 1.1.2015 to 30.9.2016
Methodology: After taking permission from the ethical committee of Bannu medical college, the study was perused. 147 infertile PCOS women were enrolled and equally divided into three groups. Group A (CC 50mg-150mg/day), Group B (CC 100mg/day + metformin 1500mg/day) and Group C (Letrozole 2.5mg/day + metformin 1500mg/day). The study was continued till pregnancy or CC resistance. All pregnant women were pursued till delivery. The significance of the study was to measure reproductive efficacies of the treatment, live birth rate (LBR), ovulation induction rate and biochemical pregnancy rate.
Results: A significant difference was observed in the percentage of women having mature follicles, ovulation induction rate and live birth rate. The ovulation induction rate, pregnancy rate and live birth rate of group C in comparison to group A was significant at p < 0.05 with odd ratio 4.57 (1.45-14.38), 3.59 (1.21-10.60) and 3.75 (1.24-11.40) respectively.
Conclusion: Letrozole along with metformin is more effective as compared to CC in inducing ovulation, achieving higher pregnancy and live birth rate in infertile PCOS women.